Provider Demographics
NPI:1588102586
Name:MCMULLEN, JESSICA A (CRNA)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:A
Last Name:MCMULLEN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:SCHAGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:6300 GREENWOOD PKWY
Mailing Address - Street 2:406
Mailing Address - City:SAGAMORE HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44067-2393
Mailing Address - Country:US
Mailing Address - Phone:216-798-2659
Mailing Address - Fax:
Practice Address - Street 1:CLEVELAND CLINIC
Practice Address - Street 2:9500 EUCLID AVE
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-798-2659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-09
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH112855367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered